Brendan Wallace, MD in Bangor, ME

Brendan Wallace, MD is a medicare enrolled "Urology" physician in Bangor, Maine. His current practice location is 55 Broadway, Bangor, Maine. You can reach out to his office (for appointments etc.) via phone at (207) 947-0469.

Brendan Wallace is licensed to practice in Maine (license number MD25666) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164159257.

Contact Information

	Brendan Wallace, MD
	55 Broadway, Bangor, ME 04401-5201
	(207) 947-0469
	Not Available

Map and Direction

Physician's Profile

Full Name	Brendan Wallace
Gender	Male
Speciality	Urology
Location	55 Broadway, Bangor, Maine
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164159257
Provider Enumeration Date: 08/08/2022
Last Update Date: 08/08/2022

Medicare PECOS Information:

PECOS PAC ID: 7214312941
Enrollment ID: I20220916001495

Medical Identifiers

Medical identifiers for Brendan Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164159257	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208800000X	Urology	MD25666 (Maine)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brendan Wallace allows following entities to bill medicare on his behalf.

Entity Name	Eastern Maine Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790789147 PECOS PAC ID: 2062315161 Enrollment ID: O20040128000088

Entity Name	Eastern Maine Healthcare Systems Inland Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376579557 PECOS PAC ID: 6305817503 Enrollment ID: O20040802001656

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brendan Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Brendan Wallace, MD 98 Fountain St, Bangor, ME 04401-3848 Ph: (613) 806-2243	Brendan Wallace, MD 55 Broadway, Bangor, ME 04401-5201 Ph: (207) 947-0469

Reviews and Comments

Urology Doctors in Bangor, ME

Dr. Ali Khavari, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 55 Broadway, Suite 2, Bangor, ME 04401 Phone: 207-973-8881 Fax: 207-947-5368
Curtis P. Ross, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 55 Broadway Ste 2, Bangor, ME 04401 Phone: 207-947-0469 Fax: 207-947-5368
Dr. Jonas Gricius, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 55 Broadway Fl 2, Bangor, ME 04401 Phone: 207-947-0469 Fax: 207-947-5368
Catlin Flynn, Urology Medicare: Accepting Medicare Assignments Practice Location: 55 Broadway Ste 2, Bangor, ME 04401 Phone: 207-947-0469

Brendan Wallace, MD - Medicare Urology in Bangor, ME